Because of treatment-resistant angina, percutaneous coronary angioplasty was performed at the same time as aortic valvotomy in a 74-year-old woman with calcific aortic stenosis and coronary heart disease. There were no complications and good angiographic, haemodynamic and clinical results were obtained. It is concluded that combined valvotomy and coronary angioplasty can be recommended as palliative treatment in elderly patients in whom operation would carry an increased risk.